Author + information
- Upasana Jarori,
- Noel Dasgupta,
- Zach Richardson,
- Deborah Green-Hess,
- Harvey Feigenbaum and
- Stephen Sawada
Background: Amyloidosis preferentially affects longitudinal fiber function in the left ventricle (LV). There is however limited information on right ventricular (RV) function in this population. This study evaluated the effects of amyloidosis on longitudinal and circumferential fiber function of the RV.
Methods: Sixteen patients with clinical or biopsy-proven cardiac amyloid and 32 controls with normal EF and no known cardiac disease underwent speckle-tracking echocardiography using GE Vivid 9 and Vivid Q ultrasound machines. Images were acquired at 45 to 70 fps in 3 views of the RV; apical 4 chamber (4C) view, medially angulated long axis (LAX) view and short axis (SAX) view at the aortic valve level. The SAX view assesses circumferential rather than longitudinal function. Strain was processed using a semi-automated software program. The average value for each of the 3 views was derived (4C and LAX with 6 segments, SAX with 4 segments) and global strain was calculated as the weighted average (16 segments). Averaged strain values were compared between groups using the unpaired t-test.
Results: RV strain was successfully assessed in 100% of the amyloid patients in all 3 views. In the SAX view, the success rate was 84% in controls compared to 100% in the amyloid group (p = 0.09). RV strain was significantly reduced in the amyloid group compared to the control group in both the LAX view (-16.7 ± 7.1 vs. -25.8 ± 4.5, p<0.001) and the 4C view (-14.5 ± 4.2 vs. -22.4 ± 3.5, p<0.001). Similarly, global strain was also reduced in the amyloids compared to the controls (-14.9 ± 5.3 vs -22.2 ± 3.2, p<0.001). In the SAX view, there was not a significant difference in strain between the subjects with cardiac amyloid (-12.7 ± 5.9 vs 15.9 ± 6.1, p = 0.1) compared to controls.
Conclusions: Strain can be measured in multiple views of the RV with a high degree of success which may be due to increased wall thickness in these subjects. Amyloidosis significantly reduces RV longitudinal fiber function. In the SAX view, lack of significant reduction in strain suggests that circumferential fiber function is relatively preserved in amyloidosis.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Advances in HCM, PPCM and Other Cardiomyopathies
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1201-266
- 2017 American College of Cardiology Foundation